Quality Assurance

in Ultrasound.

Terence Cesare
 Reasons to do US QA Program

• To make sure a system is set up correctly and

performs to specified standards.

• To maintain the consistency of the performance.

• To reveal problems at their earliest stage before

it severely interferes with the clinical practices.
 Test Objects- Phantoms
• The ideal phantom should be made of a tissue-mimicking
material.
• There are different types of phantoms for: B- mode and
Doppler- mode.
• B- mode • Doppler- mode
• Multi- purpose
• Flow Phantom
• Low contrast resolution phantom
• Spherical lesion phantom • String Phantom
• Beam profile and slice thickness phantom
• Prostate QC phantom
 Doppler Tests

• Doppler QA tests include:

– Doppler signal sensitivity
– Colour display and Gray-scale image congruency
– Doppler angle accuracy
– Range-gate accuracy
– Flow readout accuracy
 B- mode Tests
• There are many QA tests.

• The most important tests are:

– Physical & Mechanical Tests
– Display Tests
– Spatial Resolution Tests
– Uniformity Tests
– Depth of visualisation Tests
– Distance Accuracy Tests
 Physical & Mechanical Tests
• This test should be done routinely.

• This test involves checking and maintaining:

– Transducers
– Power cord
– Controls
– Video Monitor
– Dust Filters
– Scanner Housing
– Wheels & Wheel locks
 Display Tests
• The display monitor and fidelity test
can be divided into two:

• In initial setup, the monitor contrast

and brightness controls are adjusted
and the number of greyscale steps
displayed is noted.

• The follow-up consists of verifying

that the baseline number of steps are
displayed and that the monitor focus
remains adequate.
 Spatial Resolution Tests
• Spatial resolution is divided into:
– Axial
– Lateral

• Axial resolution describes the

scanner’s ability to detect and
clearly display closely spaced
objects that lie along the beam’s
axis.

• Axial resolution can be

determined by identifying the
closest two filaments in a set of
axial resolution targets that can
be clearly identified as separate
objects in the image.
 Spatial Resolution (cont.)
• Lateral Resolution describes the
instrument’s ability to distinguish
structures that are closely
positioned within the image
plane along a line perpendicular
to the beam’s major axis.

• The lateral resolution at a

particular depth is determined by
measuring the width of the
filament target at that depth.
 Uniformity Tests
• Image uniformity is assessed by scanning a uniform
region of a tissue-mimicking phantom and identifying any
deviations from the expected smooth tissue texture.

• The image is inspected to detect any

kinds of:

– vertical or radially oriented streaks

– dropouts
– reduction of brightness near edges
of the scan
– brightness transitions between focal
zones
 Depth of visualisation (DOV) Tests
• DOV is ascertained by measuring the depth in a tissue-
mimicking phantom at which usable echo information
disappears.
• The maximum DOV should remain constant over time.
Variations indicate performance degradation.
• Changes in the DOV can be caused by variation in output
intensity & receiver gain as well as damage to the transducer.
 Distance Accuracy Tests
• Distance accuracy is assessed by comparing the measured
distance between selected filament targets in a phantom with
the known distance.

• The vertical distance or depth calibration test determines the

accuracy of measured distance along the beam’s axis.

• The horizontal test assesses the accuracy of measurements

Conclusion
• As healthcare
professionals, our ultimate
goal is to provide the best
possible care for the
patient.
• Therefore, we must
assure that adequate
ultrasound image quality
is achieved and
maintained by periodic
Quality Assurance.